Date: Saturday, May 2, 2015
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Exhibit Hall E
Antibody induction therapy has been used for induction in up to 80% kidney transplant recipients according to United Network for Organ Sharing. It has been established by multiple studies that induction therapy reduce the incidence and severity of acute rejection episodes, which may improve graft survival. Most transplant centers across the United States use antibody induction with rabbit antithymocyte globulin or Alemtuzumab to minimize maintenance immunosuppression. We are presenting our experience with Alemtuzumab (30 mg iv single dose) in relation to graft survival and acute rejection rates. Our current protocol for immunosuppression includes Tacrolimus target trough level between 7-10 ng/ml, Mycophenolate mofetil (MMF) 500 mg oral twice daily, methylprednisolone 500 mg post operative day(POD) 0, 250 mg POD 1 and 125 mg POD 2 with rapid steroid withdrawal.
We performed a retrospective chart review of 426 kidney transplants performed from November 2007 to December 2011 of which 297 recipients received Alemtuzumab for induction immunosuppression and we obtained demographic, clinical data including biopsy proven acute rejection. At 1 year post transplant all patients were alive with available follow-up visits but at 3 years only 285 patients had follow up, 12 patients were lost to follow up (non-adherence) or transferred to other transplant center.
– Incidence of biopsy proven acute rejection at one year was 7.7% (23 of 297) and at 3 years was 12.6% (36 of 285).
– Graft survival was 97.4% at 1 years and 95.5% at three years (patients lost to follow-up were excluded)
– Incidence of graft failure at 1 year was 2.6% (8 of 297) and 4.5% (13 of 285) at 3 years.
– Mortality was 1.3% (4 of 297) at 1 year and 4.2% (12 of 285) at 3 years.
In our experience with Alemtuzumab, using maintenance therapy of Tacrolimus, MMF and immediate steroid withdrawal (POD 2) is an effective agent with rejection rate of 7.7% and graft survival rate of 97.4% at one year, rejection rate of 12% and graft survival rate of 94% at 3 years.
To cite this abstract in AMA style:Vaitla P, Patel U, Cruz A, Guisti S, Moiz A, Catherine C-S, Cohen A, Loss G, Bohorquez H, Carmody I, Reichman T, Bruce D, Anders S, Garces J. Long Term Outcomes With Alemtuzumab Induction Therapy for Deceased and Living Renal Transplant Recipients. A Single Center Experience [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/long-term-outcomes-with-alemtuzumab-induction-therapy-for-deceased-and-living-renal-transplant-recipients-a-single-center-experience/. Accessed October 21, 2018.
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